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Association between quality of response and outcomes in patients with newly diagnosed mantle cell lymphoma receiving VR-CAP versus R-CHOP in the phase 3 LYM-3002 study

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机构: [1]Chibanishi Gen Hosp, Chiba, Japan; [2]Univ Hosp Leuven, Leuven, Belgium; [3]Med Univ Lodz, Copernicus Mem Hosp, Lodz, Poland; [4]Sun Yat Sen Univ, Canc Ctr, Guangzhou, Guangdong, Peoples R China; [5]Cherkassy Reg Oncol Ctr, Cherkassy, Ukraine; [6]Mahidol Univ, Fac Med, Siriraj Hosp, Bangkok, Thailand; [7]Univ Sao Paulo, Fac Med, Hosp Clin, Sao Paulo, Brazil; [8]Univ Vienna, Vienna Gen Hosp, Vienna, Austria; [9]Masaryk Univ Hosp Brno, Brno, Czech Republic; [10]Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Tokyo, Japan; [11]Janssen Res & Dev LLC, Raritan, NJ USA; [12]Janssen Res & Dev, High Wycombe, Bucks, England; [13]Millennium Pharmaceut Inc, Boston, MA USA; [14]Osped San Giovanni Bellinzona, Oncol Inst Southern Switzerland, Bellinzona, Ticino, Switzerland
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In the phase 3 LYM-3002 study comparing intravenous VR-CAP with R-CHOP in patients with newly-diagnosed, measurable stage II-IV mantle cell lymphoma, not considered or ineligible for transplant, the median progression-free survival was significantly improved with VR-CAP (24.7 versus 14.4 months with R-CHOP; P<0.001). This post-hoc analysis evaluated the association between the improved outcomes and quality of responses achieved with VR-CAP versus R-CHOP in LYM-3002. Patients were randomized to six to eight 21-day cycles of VR-CAP or R-CHOP. Outcomes included progression-free survival, duration of response (both assessed by an independent review committee), and time to next anti-lymphoma treatment, evaluated by response (complete response/unconfirmed complete response and partial response), MIPI risk status, and maximum reduction of lymph-node measurements expressed as the sum of the product of the diameters. Within each response category, the median progression-free survival was longer for patients given VR-CAP than for those given R-CHOP (complete response/unconfirmed complete response: 40.9 versus 19.8 months; partial response: 17.1 versus 11.7 months, respectively); similarly, the median time to next anti-lymphoma treatment was longer among the patients given VR-CAP than among those treated with R-CHOP (complete response/unconfirmed complete response: not evaluable versus 26.6 months; partial response: 35.3 versus 24.3 months). Within the complete/unconfirmed complete and partial response categories, improvements in progression-free survival, duration of response and time to next anti-lymphoma treatment were more pronounced in patients with low- and intermediate-risk MIPI treated with VR-CAP than with R-CHOP. In each response category, more VR-CAP than R-CHOP patients had a sum of the product of the diameters nadir of 0 during serial radiological assessments. Results of this post-hoc analysis suggest a greater duration and quality of response in patients treated with VR-CAP in comparison with those treated with R-CHOP, with the improvements being more evident in patients with low-and intermediate-risk MIPI. LYM-3002 ClinicalTrials.gov: NCT00722137.

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出版当年[2017]版:
大类 | 1 区 医学
小类 | 2 区 血液学
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 血液学
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第一作者机构: [2]Univ Hosp Leuven, Leuven, Belgium;
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通讯机构: [2]Univ Hosp Leuven, Leuven, Belgium;
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